Balancing Electronic Claims

How do I know if all my claims were accepted?

1. The electronic claim log total dollar amount from PPM should match the dollar amount���� on the Imported Claim Report that is downloaded the next business day. The date on the PPM carrier log is the date that the software is on, not the calendar date.

The date on the imported claim report, which is located in the upper right-hand corner, is the date that the claims were processed.

2. Claims processing takes place at 7:30 am Monday � Friday. The imported claim report and error reports should be available after 12:00pm. If you don�t receive an imported claim report by the end of the next business day, please call the HCDS support as this may indicate a problem.

3. The carrier reports name contains a 4-digit date that should match the date on the imported claim report.� The date of the carrier report is located in the upper left-hand corner.

Example of a WI Medicare report for July 7^th, the report name would be WIM0717.xxx

(The xxx is a unique 3-digit code for each client.)

4. Carrier reports come back from the carrier 1-3 days after the date on the imported claim report. Medicare reports typically are 1day after the imported claim date. The Avality or commercial carrier reports can be any where from 1 � 3 days after the imported claim date.